BACKGROUND: As people with HIV (PWH) live longer, age-appropriate colorectal cancer (CRC) screening is increasingly important. Limited data exist on CRC screening and outcomes comparing PWH and persons without HIV. SETTING: Large integrated health care system. METHODS: This study included PWH and demographically matched persons without HIV who were aged 50-75 years during 2005-2016 and had no previous CRC screening. We evaluated time to first CRC screening (fecal test, sigmoidoscopy, or colonoscopy). We also assessed detection of adenoma and CRC with sigmoidoscopy or colonoscopy by HIV status, accounting for CRC risk factors including sex, age, race/ethnicity, number of outpatient visits, smoking, body mass index, type-2 diabetes, and inflammatory bowel disease. Among PWH, we evaluated whether CD4 count (<200/200-499/≥500 cells/µL) was associated with adenoma and CRC. RESULTS: Among 3177 PWH and 29,219 persons without HIV, PWH were more likely to be screened (85.6% vs. 79.1% within 5 years, P < 0.001). Among those with sigmoidoscopy or colonoscopy, adenoma was detected in 161 (19.6%) PWH and 1498 (22.6%) persons without HIV, and CRC was detected in 4 (0.5%) PWH and 69 (1.0%) persons without HIV. In adjusted analyses, we found no difference in prevalence of either adenoma or CRC by HIV status (adjusted prevalence ratio = 0.97, 95% confidence interval: 0.83 to 1.12). Lower CD4 count did not increase likelihood of adenoma or CRC. CONCLUSIONS: Within an integrated health care system with an organized CRC screening program, we found no disparities in CRC screening uptake or outcomes among people with and without HIV, and CD4 count did not influence CRC risk among PWH.
BACKGROUND: As people with HIV (PWH) live longer, age-appropriate colorectal cancer (CRC) screening is increasingly important. Limited data exist on CRC screening and outcomes comparing PWH and persons without HIV. SETTING: Large integrated health care system. METHODS: This study included PWH and demographically matched persons without HIV who were aged 50-75 years during 2005-2016 and had no previous CRC screening. We evaluated time to first CRC screening (fecal test, sigmoidoscopy, or colonoscopy). We also assessed detection of adenoma and CRC with sigmoidoscopy or colonoscopy by HIV status, accounting for CRC risk factors including sex, age, race/ethnicity, number of outpatient visits, smoking, body mass index, type-2 diabetes, and inflammatory bowel disease. Among PWH, we evaluated whether CD4 count (<200/200-499/≥500 cells/µL) was associated with adenoma and CRC. RESULTS: Among 3177 PWH and 29,219 persons without HIV, PWH were more likely to be screened (85.6% vs. 79.1% within 5 years, P < 0.001). Among those with sigmoidoscopy or colonoscopy, adenoma was detected in 161 (19.6%) PWH and 1498 (22.6%) persons without HIV, and CRC was detected in 4 (0.5%) PWH and 69 (1.0%) persons without HIV. In adjusted analyses, we found no difference in prevalence of either adenoma or CRC by HIV status (adjusted prevalence ratio = 0.97, 95% confidence interval: 0.83 to 1.12). Lower CD4 count did not increase likelihood of adenoma or CRC. CONCLUSIONS: Within an integrated health care system with an organized CRC screening program, we found no disparities in CRC screening uptake or outcomes among people with and without HIV, and CD4 count did not influence CRC risk among PWH.
Authors: Adil Faqih; Amit G Singal; Hannah M Fullington; Benjamin Hewitt; Ezra Burstein; Purva Gopal; Annika Wylie; John Abrams; Caitlin C Murphy Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-05-28 Impact factor: 4.254
Authors: Jennifer O Lam; Tory Levine-Hall; Nicole Hood; Stacey E Alexeeff; Michael A Horberg; Kelly C Young-Wolff; Stacy A Sterling; Andrew Williams; Constance Weisner; Derek D Satre; Michael J Silverberg Journal: Drug Alcohol Depend Date: 2020-06-18 Impact factor: 4.852
Authors: Natalie E Chichetto; Brittanny M Polanka; Kaku A So-Armah; Minhee Sung; Jesse C Stewart; John R Koethe; E Jennifer Edelman; Hilary A Tindle; Matthew S Freiberg Journal: Curr HIV/AIDS Rep Date: 2020-08 Impact factor: 5.495
Authors: Julia L Marcus; Wendy A Leyden; Stacey E Alexeeff; Alexandra N Anderson; Rulin C Hechter; Haihong Hu; Jennifer O Lam; William J Towner; Qing Yuan; Michael A Horberg; Michael J Silverberg Journal: JAMA Netw Open Date: 2020-06-01